Getting lectured by the pharmacist at each script drop off

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Avid1
New Member


Date Joined Jul 2018
Total Posts : 5
   Posted 9/6/2018 2:43 PM (GMT -6)   
I've been seeing a pain management doctor for 2 years now. I don't want to get into all of my surgeries (it would take a while)but will answer any questions from you guys .
I have been with the same pharmacy for years. I don't know why, but the head pharmicist has lectured me about my prescriptions the last 3 times i dropped them off. Her lecture is about how there are "studies" that show that the morphine equlivent of what i take is way too high because these studies show that a lower amount does the same thing.

Unfortunately i have been in chronic pain for years and know not to argue with a pharmacist because it can be torture to try to find a new place yo fill scripts. The forst time she did this, i was annoyed. I shouldn't have to tell her my history. Especially when the place i go to is a supermarket pharmacy with my friends and neighbors in earshot of her and myself. Also because frankly, it is none of her business. My doctor knows everything about me, what has happened to me, my surgeries, what meds work, what meds don't. He is not only a pain management doctor but also a practicing anastiologist. He knows his medications way more that the pharmacist.

After the second lecture by the same pharmacist, on my next visit to the pain management doctor i told them about this and about how uncomfortable i was . I asked them what i should do if it happens again. They told me to stay calm and tell her that if she has any questions or concerns to call them directly. They unfortunately have had to deal with this before with pharmacist's.

So today, i drop off. There she goes again with her lecture. So i lean into the booth and say, i spoke to my doctor about you. If you have concerns or questions he told me to have you call him . Well then she said... ohhhh , ahhhh , well it will take too long (or something along those lines). That's when i got annoyed but am proud of myself that i held my composure, and said - i go to a specialist for a reason. Please call them if you have concerns about this.
She finally stopped (for today).

Was wondering if it's just me or if others have dealt with this also.
Oh, also i know i mentioned this already but my scripts are written properly. They say for non acute pain . And this is from a pain management doctor. I know that the laws have changed. But i am doing nothing wrong. I wonder if she is looking at me thinking that im not in the pain that I'm in every day because im not hobbling in to drop off my prescriptions. Idk but this is getting annoying.

pitmom
Veteran Member


Date Joined Jan 2015
Total Posts : 2407
   Posted 9/6/2018 2:54 PM (GMT -6)   
First, let me say that I love your doctor! What an excellent way to respond!

As for the pharmacist...yikes! On the one hand, I understand the concern and I hope that is the only motivation this person has to say anything at all.

I use a 'small town, mom and pop' pharmacy and have had no problems...yet. I, too, have had multiple surgeries leaving me with chronic pain as well as DDD and other issues but do not 'look' disabled or what others must imagine a chronic pain patient is supposed to look like.

Hopefully, the pharmacist will get off her soapbox the next time you have to drop off a script.
multiple surgeries for rotator cuff both shoulders with residual chronic impingement syndrome, ulnar nerve transposition, carpal tunnel release, multiple wrist surgeries, multiple herniated discs, tarlov cysts, whiplash, bursitis of hips, grade 5 right shoulder separation and torn labrum, ovarian cysts, fibroid tumors of the uterus

Avid1
New Member


Date Joined Jul 2018
Total Posts : 5
   Posted 9/6/2018 3:41 PM (GMT -6)   
Thank you Pitmom for your reply.
I was sad at first that my pain management doctor has had to speak to pharmicists directly that question his prescriptions. But on the other hand he did say that once he explains (calmy) that the reason that certain medications are prescribed are because they've tried everything else with no relief for the patientsand this is when he has to prescribe higher doses or stronger medicines that then the pharmacists agree with him. He said that he's only had 1 that would not budge from their own opinions and stance.

I was really happy that he was so nice about telling me to just tell them to call him directly and that he would handle it.

Just sucks that a pharmacist is questioning a pain management doctor with her (the pharmacist) not knowing a darn thing about what I've been through. She shouldn't even be lecturing me. Ok, maybe one time, i might have understood. But 3 times, the same thing....
I so wanted to snap and tell her the hell I've been through but in retrospect I'm glad i didn't. For so many reasons. The main one being --- it's none of her f ing business. There are HIPPA laws for a reason.
Luckily i have a great doctor and he has a really good staff.

Hope the rest of you don't have to deal with this.

GreenBeans
Regular Member


Date Joined Dec 2016
Total Posts : 46
   Posted 9/6/2018 3:56 PM (GMT -6)   
I've been seeing the same rheumatologist for over 12 years. He is very familiar with my Lupus, Fibromyalgia, Sjogren's and Arthritis issues. This includes the prescription for 60 Norco pain tablets to use as needed - the 60 usually last me 8-10 months.

So yesterday he had his new PA see me instead of attending my appointment himself. She wanted to switch my pain med to Lyrica (which we tried a decade ago that didn't help). She also wanted to know if I'd like to try Plaquenil instead. (Plaquenil is for suppressing Lupus, not for pain, and I was on it for 15+ years before my Lupus improved and I don't need it anymore.)

Thankfully I smiled, said we had done all that in the past, that my condition is stable and I just needed my refills and my disability form signed. (All the time I wanted to scream out something really rude about "If you'd read my file you'd know better"....) Or if she'd ever bothered to ask "What brings you in today?" she might have gotten done faster.

So all that to say -- your pharmacist probably has no idea she tried to give you the lecture before. Doesn't excuse her from butting into the Dr's business and trying to change things up, but.... I know what you're talking about, and people can be so awful for no good reason!!!

Darla
Regular Member


Date Joined Jun 2018
Total Posts : 150
   Posted 9/7/2018 6:00 AM (GMT -6)   
Hi Avid,

I go to a small 'Mom and Pop' pharmacy and have gotten the same thing. I was using a supermarket and had no trouble filling my scripts but I am not driving any longer because I can't with my meds and my husband preferred the closer pharmacy. The smaller one 'counseled' not only me but my husband! What about HIPPA? If he is picking up or dropping off the scripts/meds they whined to him about them. They did contact the primary care dr who was doing the muscle relaxers and sent him an article to read! He said pharmacists think they are the Dr. I started bringing in my patient summary after my PM visits and then they calmed down. I do feel hostage to getting all my arthritis meds and general stuff filled with them because they don't want to only fill the pain meds. We have worked out a good relationship over time but every month I have to wait an extra day while they order the meds. I would think they could anticipate it and have it stocked after years of the same RX but it is tolerable. And the pharmacist did give me his cell phone for a hurricane med pickup...Pro's and con's of a small pharmacy I guess. Let's face it the world thinks people on pain meds are junkies. I also don't look too bad and that makes it look like I am not needing the meds.

Green Beans, Hi nice to meet you! I am interested in your experience with plaquenil. I would also like to talk to you about the Sjogren's. I will do a separate post because I don't want to hijack Avid1s. So sorry!

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16804
   Posted 9/7/2018 7:07 AM (GMT -6)   
Avid1, welcome to Healing Well. Two months ago I was grilled by a new pharmacist too. This is where we have been getting all of our scripts filled for years. It’s very busy with customers milling around & there is no privacy. I was asked why I was asked what condition I had to be taking it! I just looked at him & said I don’t have a condition, I have multiple conditions. I have never been questioned in all of my years by a pharmacist.

I did discuss this with my PM dr & he said if this ever happens again, tell them to call me. He said their role is to fill prescriptions & look for interactions with any other medication a patient may be taking. They cannot ask your health history.
Susie
Moderator in Chronic Pain & Psoriasis Forums

Darla
Regular Member


Date Joined Jun 2018
Total Posts : 150
   Posted 9/7/2018 10:07 AM (GMT -6)   
Susie, Avid, GB...To me this is a symptom of the general climate. People on pain meds are not deserving of compassion or understanding. Rather, they are either misguided and need to be educated about the medication or up to something. What about respect and compassion.

Avid1
New Member


Date Joined Jul 2018
Total Posts : 5
   Posted 9/7/2018 4:13 PM (GMT -6)   
Thank you GreenBeans, Daria, and Straydog for your replies. I'm sorry that you have had to go through the things that you each mentioned.
It is so hard dealing with chronic pain daily. Especially when you don't have friends or family members who truly understand what this is like. I really appreciate your replies, thoughts and experiences. I'm really glad to be here.

(Seashell)
Veteran Member


Date Joined Dec 2012
Total Posts : 893
   Posted 9/8/2018 2:30 AM (GMT -6)   
As an individual myself on prescription opiates, I can appreciate the inherent discomfort and sense of unfair personal attack when questioned and scrutinized by a pharmacist.

Recognize that the makings of the current “opiate crisis” does have legitimacy. Cases of pill mill pain clinics, dispensing prescriptions for opiates that exceeded any reasonable need; physicians accepting lavish gratuities from Purdue Pharmaceuticals who agreed to lecture at educational seminars supporting expanded use of opiates; diversion of prescription opiates, often a family member or acquaintance looking through a bathroom cabinet and taking medication prescribed to someone else.

Legtimate pain patients are caught in the cross fires. Collateral damage.

Opiates are powerful medications and they need to be respected as such.

That pharmacists are asking questions is not necessarily bad or misguided.

How many of you are aware that long-term opiate use causes suppression of the HPA axis (hypothalamus-Pituitary-adrenal axis) and endocrine related disorders? Probably very few. HPA suppression is also not strongly recognized by opiate prescribing physicians and, lacking accurate diagnosis, can leave people languishing.

Opiate induced adrenal insufficiency is real and is estimated to affect between 10-20 % of chronic pain patients on long-term opiates. Opiate induced secondary adrenal insufficiency was the basis for issuing a Black Box warning on opiates by the CDC/NIH/DEA prescribing guidelines issued in April-2016.

I already had Addison’s disease (primary adrenal insufficiency) when I began taking prescription opiates. The risk of HOA suppression was a moot point for me. I already have complete Pituitary failure (pan-hypopituitary) and complete HPA suppression.

I can tell you, unequivocally, that I would not wish adrenal insufficiency on my worst enemy. It is a truly debilitating disorder that adversely affects the entire body. The bulk of my health challenges are endocrine-based.

To wit: Do not be too harsh on a pharmacist who may ask you questions about the dosage you are prescribed. Opiate dosing over a sustained period of time will suppress the HPA axis. You can not necessarily trust that your prescribing physician has an awareness of opiate induced HPA suppression and its ramifications. It serves us all well to be fully informed. Knowledge is power. Striving to take the lowest dosage of opiate that balances the ability to function and retain mental sanity is key. If a pharmacists’ questions cause you to stop, pause and reflect on your opiate prescription that in itself can serve a greater good and a greater purpose.
Karen
Pituitary failure, wide-spread endocrine dysfunction
Addison's disease
Mixed connective tissue disorder
Extensive intestinal perforation with sepsis, permanent ileostomy
Avascular necrosis of both hips and jaw
Receiving Palliative Care (care and comfort)

Darla
Regular Member


Date Joined Jun 2018
Total Posts : 150
   Posted 9/8/2018 8:51 AM (GMT -6)   
Karen, as always you have such extensive knowledge and interesting, thought-provoking questions. I think there is no excuse for the Pharmacists to not respect us as adults. Privacy is the law. Respect is expected. If the prescription is not appropriate that is a different issue. The time and information the Dr has exceeds the Pharmacist's two second question in my opinion. They should speak to the Dr, with the patient's permission if they are so concerned.

Avid...Very nice to meet you!

Ljm2014
Veteran Member


Date Joined May 2014
Total Posts : 2229
   Posted 9/9/2018 12:15 AM (GMT -6)   
Even with good intentions of a pharmacist..that atmosphere where they are lecturing in public, is inappropriate...this needs to be between the dr and the patient..they do not know your circumstance.

No one wants to take pain meds, there are usually side effects, even ones we do not understand.., still i think just saying, you can call my dr. Is a good idea.

Avid , i am glad you have a dr who will work with you..lj

bigecase
Regular Member


Date Joined Mar 2010
Total Posts : 384
   Posted 9/9/2018 5:36 AM (GMT -6)   
Some pharmacist may mean well but we have a different relationship with our doctors. Our doctors are reviewing tests and imaging and know are complete history. They know what we have going on. How many surgeries and how pain keeps us up all night. They know we have tried everything in the book. We are not addicted but dependent to function to the best of our ability at this point in life. Sorry. I woke up hurting more than usual this morning. I use a local pharmacy and never had any trouble.
bigecase
Age 49

bulging disc C6, c7, L4 &L5, L5S1 Spinal Stenosis, degenerative disc, mild anterolisthesis FAILED back Surgery 2012. Torn rotator cuff, torn bicep tendon, and spurs all in right shoulder--3 shoulder surgeries. ESOPHYX TIFF surgery. Hypothyrodism, anxiety, migraines, tmj,3 left shoulder surgeries
12/14, SCS implant

Lendi
Regular Member


Date Joined Mar 2018
Total Posts : 336
   Posted 9/9/2018 12:29 PM (GMT -6)   
Just a guess but the pharmacist may also be covering her butt. People are sue happy and it's a sure bet that at some point they have been sued (or heard of it) by someone who blames them for not warning them about a possible problem. The laws are such that the medical profession has to walk a small edge when it come to medication and handling it. It's sad.

I wouldn't take offense the first time, after that I'm afraid I wouldn't have had your patience.
What if trials of this life are Your mercies in disguise.

Laura Short

"Blessings"

Darla
Regular Member


Date Joined Jun 2018
Total Posts : 150
   Posted 9/9/2018 1:45 PM (GMT -6)   
It is such a tough situation because you can feel very impatient with this on the inside but if you express anything to the pharmacist (or Dr for that matter) you risk being denied the medication because you are difficult. Technically I don't think they are supposed to be that easily rid of an assertive patient but I am not taking a chance.

Mercy&Grace
Veteran Member


Date Joined Jun 2013
Total Posts : 1729
   Posted 9/11/2018 10:59 AM (GMT -6)   
Seashell makes good points. .as always. In addition countless patients that were on high doses of opiates and had to reduce or stop their pain meds. Have realized they do not need the opiates like they thought they did. This takes time. For years chronic pain patients were told they had to have opiates. They would be on them the rest of their lives. Patients were also told taking opiates long term was not harmful. That was based on incorrect information. Addiction and overdose are not the only risks.

Do you know how long the pharmacist has been there ? Or when she graduated from pharmacy school? Pharmacists recently out of school do not have the knowledge and experience of working with patients. They go by the book because this is all they know at this point.

Chances are the store has instituted a new policy. All pharmacists have to counsel patients receiving opiate prescriptions at each fill. Pharmacists deal with countless patients. They do not remember anything about the patients. Including if/when a patient was counseled.

Post Edited (Mercy&Grace) : 9/11/2018 10:03:47 AM (GMT-6)


Avid1
New Member


Date Joined Jul 2018
Total Posts : 5
   Posted 9/13/2018 6:50 PM (GMT -6)   
I read all of the replies and appreciate all of you guys .

I read everything that Seashell said and absolutely agree that knowledge is power.

The only thing that i might differ with you on is that i don't think that the pharmacist should be lecturing me (i say this because she has said the exact same thing to me 3 times now, even though I told her my doctor said she should call them if she had questions or concerns about the medication).
Especially because i have been with the same pharmacy for years and the woman who does this to me is the main pharmacist. No one else bothers me. Or i should say, no one else tells me that the morphine equivalent of what i am prescribed is higher than the studies that she has read of. Also, i have NEVER heard any other pharmicist there speak to a customer this way. It's just not right.

She has no clue what i have been through. No clue the amount of surgeries that i have had. No clue how many ridiculous things that I have tried (magnets, subliminal tapes to help with pain, p.t., chiropractors, shots,lasers, cryosurgery to freeze facial nerves to try to stop the pain in that area) basically everything and anything OTHER than medication to help my pain.

This is why i have a pain management doctor. He knows what I've been through , what I've tried, what has worked, not worked, etc.....

Not trying to be a jerk but she is a pharmacist. She is there to fill my prescriptions. I have never broken a law. I even told her that she could call my doctor if she was that concerned (she hasn't ).

Also, as i said before i go to a supermarket pharmacy. Unfortunately there is no privacy anywhere. The tiny "drop off area" is right where everyone walks in. The tiny "pick up area" is where the lanes empty out to and where everyone walks by to exit.

Again, I'm sorry if I am coming across strong or jerkily. I'm just so frustrated. I have not heard another pharmacist talk to a customer like or about this before. And this is where i shop and unfortunately like i said, customers can see and hear a lot walking in and checking out (and i mean customers, not just pharmacy customers).

I really hope that this doesn't happen next month. And i a billion percent really hope that this doesn't or hasn't happened to any of ya all.

Post Edited (Avid1) : 9/13/2018 6:13:01 PM (GMT-6)


bigecase
Regular Member


Date Joined Mar 2010
Total Posts : 384
   Posted 9/13/2018 7:00 PM (GMT -6)   
If this is a chain grocery i would email headquarters and let them know. Tell them your concern for your privacy due to the traffic.
bigecase
Age 49

bulging disc C6, c7, L4 &L5, L5S1 Spinal Stenosis, degenerative disc, mild anterolisthesis FAILED back Surgery 2012. Torn rotator cuff, torn bicep tendon, and spurs all in right shoulder--3 shoulder surgeries. ESOPHYX TIFF surgery. Hypothyrodism, anxiety, migraines, tmj,3 left shoulder surgeries
12/14, SCS implant

Ljm2014
Veteran Member


Date Joined May 2014
Total Posts : 2229
   Posted 9/13/2018 9:53 PM (GMT -6)   
I do not like it at all, just go with call my dr..stay polite..

Some who have no control in their own lives will try to be controlling to others..

Something i would try, would be to pray over it...that she might have a light bulb moment not to embarrass the customer..its out of line..

Kinda wonder if it makes her feel important that others can hear..🙄

(Seashell)
Veteran Member


Date Joined Dec 2012
Total Posts : 893
   Posted 9/13/2018 11:25 PM (GMT -6)   
Avid:
Believe me, I have had similar experiences to yours of being unilaterally judged by pharmacy staff when picking up a narcotic prescription. I would cringe when walking to the pharmacy pick-up counter, not knowing whether there would be a uneasy encounter. These episodes occurred during the first few months that I was on prescription narcotics - which also happened to be early 2016 when the CDC prescription guidelines had been released (formal CDC report was issued in April 2016).

It was a very visceral experience. I felt a pit in my stomach. I was anxious, hyper-vigilant. I felt as though I was a common criminal in the eyes of the pharmacy staff.

I was already a “frequent flyer” at the pharmacy as I have routine monthly prescriptions to correct for Pituitary failure.

I can appreciate your growing frustration with the pharmacist encroaching on your personal boundaries.

I think your strongest position is to continue to reply to the pharmacist in a calm and non-confrontational manner as you have been doing. “I appreciate your concern but ask that you contact my physician directly rather than counsel me again.”

Possibilities:

There may be corporate stipulations or demands being placed on the pharmacist that ask of her to interject herself and promote less opiate reliance when patients pick up a script. Many of the large/national pharmacy conglomerates are tightening pharmacist counseling surrounding opiates and benzodiazapines (ex. Walgreens, CVS).

If the pharmacist is acting maliciously as a bully or explicitly wanting to establish a base of superiority/power over you, then the less you engage with her the better. A mean-spirited bully wants to elicit a strong reactive response in his/her victim. By not reacting dramatically to the pharmacists’ taunts veiled as counseling, you are not giving her the response that she wants to further fuel her. She loses power when you respond calmly and politely, with 1-2 sentences.

Writing a letter of notification/complaint to the corporate pharmacy office would also be an avenue for you to pursue.

Let us know before you plan to pick up your next narcotic prescription at the pharmacy. We can send positive karma into the universe for you. The power of collective goodwill.
Karen

Post Edited ((Seashell)) : 9/13/2018 10:33:05 PM (GMT-6)


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16804
   Posted 9/14/2018 7:44 AM (GMT -6)   
Avid, I would send the corporate office either an email or letter about this. A new pharmacist ok, she gives her speech on the first encounter with you. But, three times is out of line as far as I am concerned. My biggest concern is “lack of privacy”. The setting you are describing puts you at risk. People hear what is being said & if the wrong person were to overhear the conversation, you could be followed to your car. Yes, things like this has happened. I know this setting very well. I am not some paranoid person either.

Several years ago I fell & broke my arm. I carried a small purse. I couldn’t handle the purse & cane, I ditched the purse. To this day i carry my license & debit card in my pocket. My scripts are folded up & put in the other pocket. My NP at my pain mgt office, said every patient has to be very careful. Like she said the scripts & meds are worth a lot of money.

I don’t think your attitude about this is being snarky or a jerk. It’s about safety & an arrogant pharmacist.
Susie
Moderator in Chronic Pain & Psoriasis Forums

(Seashell)
Veteran Member


Date Joined Dec 2012
Total Posts : 893
   Posted 9/14/2018 10:59 AM (GMT -6)   
Avid:
Have you considered moving your prescription to a new pharmacy?

I was with Rite-Aide for years but became disenchanted when newly issued corporate policies took away from the neighborhood-feel of my local store. I am happyily established with a new pharmacy that fits my needs.

Pharmacies are like any business seeking new shoppers. Even with a pain contract, you have the option to change to a new “home” or primary pharmacy.
Karen

1 day at a time
Regular Member


Date Joined Nov 2012
Total Posts : 304
   Posted 9/15/2018 6:13 PM (GMT -6)   
I use a chain pharmacy but am lucky in that the "regular" pharmacists know me well enough to let it go. Floats however are an annoyance, especially new grads. I was told that all of the pharmacies in the area were recently "visited" by the DEA who apparently tried to scare them enough that they're afraid of losing their license. The new grads are not only being educated about "the evils of the use of opiates" but are also green enough to not be able to see the bigger picture. Therein lies the rub. The seasoned pharmacists are retiring and we have a new crop of kids who were taught differently (physicians included). I absolutely adore the primary pharmacists (& techs) at the chain I use but those new kids are really full of themselves. Total power trip.

rjbeck
Regular Member


Date Joined Feb 2008
Total Posts : 257
   Posted Yesterday 3:43 AM (GMT -6)   
I have this problem at the CVS I use. I have been going there for 9yr's and when my refill falls on a weekend and they are using a fill-in pharmacist that's when I get the lecture about the methadone and oxycodone I am using. I've had a pharmacist refuse to fill it. So I took my scripts and went across the street to Walgreens. These are pharmacists that have become very paranoid of the DEA.

Lynnwood
Veteran Member


Date Joined May 2005
Total Posts : 7725
   Posted Yesterday 11:27 AM (GMT -6)   
I've had great success using the CVS across the street from the hospital -- my theory is that they are too busy at that location to get too nosy about who is taking what!

Avid1
New Member


Date Joined Jul 2018
Total Posts : 5
   Posted Yesterday 3:40 PM (GMT -6)   
Thank you all for your replies first and foremost.
I had my monthly appointment this morning. When i went to the pharmacy to fill one of the prescriptions, i didn't recognize the new guy. But turns out his picture is on the wall as the head/main pharmicist. (The "lecture lady" is now the second in command).
Anyway, i walked up gave him my hydrocodone script (the main one isn't due until the 9th). He went on the computer for a bit then asked me if the prescription was for break through pain. I said yes. (The lady never asked me this, just gave me the lecture). So like for a hot minute i am thinking in my head, wow maybe this guy understands chronic pain.

Well then after that, he asks me, "how often do you take this?"
Well without thinking AND with my back throbbing in pain, i said to him - 'why are you asking me this' ?

*Sorry, i was in major pain & had a sports massage 2 days earlier that helped a bit but the muscles locked up last night and this morning So i was in a crappy mood.

Well, he replied - "Because I'm your pharmacist and I need to know".

Instead of sayin, - Well, why don't you read the f'ing script ?

I actually took a breath and said - "I take it once a day but try not to take it unless it's absolutely necessary ".

I had to go back later to pick it up. As i was thinking about this, i realized that i may be coming across as a bit#h, especially since my back and neck were f'n killing me and he doesn't know this. I just seem really mean.

So when i went back to pick up the hydrocodone medication, i did say to him, I'm sorry for being so short with you. I just really don't feel good today. He was actually nice , looked at me and said, no problem (in a nice way).

Not sure what will happen next month , or what will happen when i fill my other script on the 9th but i hope it gets better.

Gotta thank you all for the positive feedback , ideas and talking about what you all have been through. It seriously helps more than you know.
Also to Rjbeck, i also take methadone as the main pain medication so i appreciate you saying that you take this also. I've had a bad experience with oxycodone as the main one but methadone and hydrocodone as break through pain relief is really working for me.

Post Edited (Avid1) : 9/24/2018 2:51:57 PM (GMT-6)

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